颞下颌关节紊乱病患者翼外肌MRI直方图纹理特征分析

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目的:采用MRI直方图纹理分析技术评估颞下颌关节紊乱病(temporomandibular disorder,TMD)患者的翼外肌功能变化。方法:纳入2016年5月至2020年4月于解放军总医院海南医院放射科门诊就诊的28例TMD患者,男性15例,女性13例,年龄(26.2±12.1)岁(15~62岁);同时门诊招募13名颞下颌关节正常志愿者,男性6名,女性7名,年龄(23.5±3.3)岁(20~30)岁。所有受试者均进行双侧颞下颌关节MRI扫描,根据关节盘移位情况分为TMD关节盘位置正常侧(disc without displacement,TMD-DwoD)组(38侧)、TMD关节盘不可复性向前移位侧(disc displacement without reduction,TMD-DDwoR)组(18侧)、正常对照关节盘位置正常侧(normal control-Disc without displacement,NC-DwoD)组(26侧)。采用感兴趣区法测量闭口位时颞下颌关节翼外肌上肌腹与下肌腹面积、平均信号强度、信号强度变异系数、偏度及峰度等直方图纹理参数。结果:翼外肌上腹TMD-DwoD组的面积[(67.36±30.23) mmn 2]显著小于NC-DwoD组[(91.42±45.01) mmn 2](n P0.05);TMD-DwoD组及TMD-DDwoR组的平均信号强度(分别为304.20±29.90和315.06±40.20)均显著大于NC-DwoD组(269.79±25.54)(n P<0.05);TMD-DwoD组变异系数(8.89±2.60)显著大于NC-DwoD组及TMD-DDwoR组(分别为6.76±1.82和7.63±1.62)(n P0.05)。TMD-DwoD组及TMD-DDwoR组的翼外肌下腹平均信号强度(分别为286.69±23.48和275.98±30.55)显著大于NC-DwoD组(243.56±17.04)(n P<0.05);TMD-DwoD组及TMD-DDwoR组变异系数(分别为9.96±2.24和10.25±1.96)均显著大于NC-DwoD组(8.49±1.94)(n P<0.05);TMD-DwoD组及TMD-DDwoR组的偏度(分别为0.90±0.94和0.73±0.97)显著小于NC-DwoD组(1.40±1.03)(n P0.05)。n 结论:MRI直方图纹理分析技术可初步作为颞下颌关节紊乱病患者翼外肌功能的评价工具。“,”Objective:To evaluate the functional changes of lateral pterygoid muscle (LPM) in the patients with temporomandibular disorders (TMD) using histogram texture analysis.Methods:A total of 28 TMD patients, including 15 males and 13 females, aged (26.2±12.1) years (15-62 years), were enrolled in the outpatient clinic of Department of Radiology, Hainan Hospital of Chinese PLA General Hospital from May 2016 to April 2020. At the same time, 13 volunteers with normal temporomandibular joint [6 males and 7 females, aged (23.5±3.3) years (20-30) years] were recruited. All participants were performed with temporomandibular joint MRI scan, and the subjects were classified into 3 groups according to the disc displacement: TMD with disc without displacement (TMD-DwoD), TMD with disc displacement without reduction (TMD-DDwoR) and NC with disc displacement without reduction (NC-DwoD) for each temporomandibular joint. The area, signal intensity, coefficient of variation (CV) of mean signal intensity and histogram texture of the superior belly of LPM (SBLPM) and inferior belly of LPM (IBLPM) were measured using regions of interests.Results:The area of SILPM presented significantly smaller in TMD-DwoD [(67.36±30.23) mmn 2] compared with that in NC-DwoD [(91.42±45.01) mmn 2] (n P0.05). The mean signal intensity of SBLPM was identified significantly higher in TMD-DwoD (304.20±29.90) and TMD-DDwoR (315.06±40.20) compared with that in NC-DwoD (269.79±25.54) (n P<0.05). The CV of mean signal intensity of SBLPM presented significantly higher in TMD-DwoD (8.89±2.60) compared with that in NC-DwoD (6.76±1.82) and TMD-DDwoR (7.63±1.62) (n P0.05). The mean signal intensity and CV for IBLPM presented significantly higher in TMD-DwoD (286.69±23.48 and 9.96±2.24, respectively) and TMD-DDwoR (275.98±30.55 and 10.25±1.96, respectively) compared with that in NC-DwoD (243.56±17.04 and 8.49±1.94, respectively) (n P<0.05). The skewness showed significantly lower in TMD-DwoD (0.90±0.94) and TMD-DDwoR (0.73±0.97) compared with that in NC-DwoD (1.40±1.03) (n P0.05).n Conclusions:The MR histogram texture analysis could primarily be considered as a tool to evaluate the LPM function in TMD patients.
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